Prescription opioid painkillers are useful to treat moderate to severe pain. However, they’re also highly addictive when misused, abused, or taken in high doses for too long. The CDC estimates that 125 million opioid prescriptions are made each year, and 5 million Americans report struggling with a prescription opioid use disorder.
Two common prescription opioids are Vicodin and Percocet. They’re both semi-synthetic opioids, which means they’re made in a lab using natural compounds and are a combination of opioid pain relievers and acetaminophen (the main ingredient in Tylenol).
While these drugs have many similarities, there are also some differences to consider when you’re prescribed them or seeking treatment for opioid addiction.
Here, we’ll provide a general comparison of Vicodin vs. Percocet so you understand the ingredients, effects on the body, and potential for addiction.
Understanding Vicodin and Percocet
Let’s start by reviewing the properties and primary differences between these two medications.
What Is Vicodin?
Vicodin contains a combination of hydrocodone and acetaminophen.
Hydrocodone is the opioid pain-relieving component that binds to opioid receptors in the central nervous system (CNS). Opioid receptors send pain signals from the brain to the rest of the body. Drugs that bind to them will slow and reduce those signals to lower the amount of pain you feel.
Acetaminophen is a lighter pain reliever and fever reducer found in over-the-counter medications like Tylenol. It complements hydrocodone’s effects by altering the brain’s pain regulation processes.
What Is Percocet?
Percocet contains a combination of oxycodone and acetaminophen.
Oxycodone is another opioid pain reliever that has the same mechanism of action as hydrocodone. It binds to the brain’s opioid receptors to reduce pain signals. Then, acetaminophen complements the pain-relieving effects.
Key Ingredients Compared
What’s the difference between hydrocodone and oxycodone? Here’s how they compare in terms of strength and effects on the body.
Hydrocodone vs. Oxycodone Explained
The main difference between oxycodone and hydrocodone is their strength. Generally, oxycodone is considered stronger than hydrocodone, so it may be more likely to get prescribed oxycodone to treat severe pain. A study from the Journal of Drug and Alcohol Dependence found that oxycodone was 1.5 times stronger than hydrocodone.
However, some studies also show that they can perform about the same, depending on the condition being treated. For instance, a study conducted by Dr. David Swanson of the University of Virginia found that oxycodone and hydrocodone were equally effective when treating musculoskeletal extremity pain, including fractures.
Additionally, most research shows that oxycodone has a higher occurrence of side effects, especially severe side effects. For example, the study referenced above from Dr. Swanson also showed that patients who took oxycodone were more likely to experience nausea and dizziness.
Acetaminophen Dosage and Liver Risk
Both Vicodin and Percocet contain acetaminophen as a lighter, complementary pain reliever. Vicodin typically contains 300-325 mg of acetaminophen, and Percocet usually contains 325 mg of acetaminophen.
A big risk of abusing Vicodin or Percocet as recreational drugs is that high doses of acetaminophen can cause liver damage.
Research from the National Institutes of Health (NIH) shows that there are very minimal health risks when taking acetaminophen at low doses, so taking doses recommended by your doctor would be safe. However, in high doses, it can be toxic to the liver and cause acute damage. It’s a big reason why seeking treatment for Vicodin or Percocet addiction is crucial for health and safety.
Medical Uses and Pain Relief Effectiveness
Overall, the research on Vicodin and Percocet shows they’re both highly effective for treating moderate to severe pain.
What Types of Pain Are They Used For?
Percocet and Vicodin are commonly prescribed for pain from injuries, accidents, after surgery, or treating severe pain from conditions like cancer. Due to their addictive potential, they’re usually prescribed for short-term pain relief. However, they’re sometimes used to treat severe chronic pain under the supervision of a pain specialist.
It’s important to follow the dosage and guidelines from your doctor to ensure safety and reduce the risk of addiction.
Which Is More Potent or Long-Lasting?
Research from the Department of Health and Human Services (HHS) shows that Vicodin (hydrocodone) typically lasts longer, but the peak effects of Percocet (oxycodone) are usually felt faster and for a longer duration.
That’s why you’ll hear some refer to Percocet as the stronger medication when treating certain conditions, since patients will feel the most intense effects for longer.
Here’s a quick table breaking it down:
| Duration of Effects | Percocet (oxycodone) | Vicodin (hydrocodone) |
| Onset of Effects | 15 minutes | 15-30 minutes |
| Peak Effects | 1-2 hours | 0.5-1 hour |
| Total Duration | 3-4 hours | 4-6 hours |
Side Effects and Interactions
Vicodin and Percocet share several similar side effects since they’re both opioids. Those include:
- Dizziness
- Drowsiness
- Vomiting
- Nausea
- Itching
- Headaches
- Stomach pain
- Constipation
Unique side effects reported for Percocet include sweating, bloating, changes in taste, heartburn, and muscle aches or pain.
Other side effects reported for Vicodin are brain fog and fatigue.
Drug Interactions and Alcohol Dangers
Both of these medications list similar interactions with other substances. It may be dangerous to take them with:
- Alcohol
- Sleep medications
- Muscle relaxants
- Benzodiazepines
- Antiseizure medications
- Some antibiotics, antidepressants, and HIV medications
Opioid medications like Vicodin and Percocet are both depressants, meaning they slow down the CNS. Therefore, taking them with other depressants like alcohol can be dangerous since it can amplify those effects to harmful levels for the mind and body, leading to more side effects, irrational behavior, or potential for overdose.
Addiction Risk and Abuse Potential
Vicodin and Percocet both have a high potential for addiction when misused or abused in high doses or taken over an extended duration of time. Someone can even get addicted to these drugs after short-term use when they’re consumed in high doses.
Is Percocet More Addictive Than Vicodin?
There is conflicting research on whether Percocet or Vicodin is more addictive.
A study in 2013 on patients seeking treatment for opioid addiction found that 15.3% more patients stated that oxycodone was their drug of choice compared to hydrocodone due to the stronger high that oxycodone-containing drugs like Percocet produce.
However, another study in 2019 found that hydrocodone had a 9% greater risk of long-term use that oxycodone.
In either case, both drugs are highly addictive, and early intervention for addiction is essential to prevent longer-term side effects of opioid abuse like damage to the liver, kidneys, and cardiovascular system.
How Tolerance and Dependence Develop
One of the main effects that contributes to dependence on opioids like Vicodin and Percocet is they trigger the release of several “feel-good” hormones in the brain, like dopamine, GABA, and serotonin. The release of those hormones creates the pleasurable effects felt when taking opioids in high doses.
However, the body gets used to consuming opioids over time, and it will require higher doses to feel the same effects, known as building a tolerance. Then, as someone takes higher doses, the brain will become more dependent on the substance to trigger the release of those essential hormones rather than producing them naturally.
It’s why someone can feel off or like they can’t function normally when they suddenly stop taking a substance.
Withdrawal Symptoms and Timeline
Common Percocet and Vicodin withdrawal symptoms felt after stopping them are:
- Hot and cold flashes
- Increased anxiety or irritability
- Strong cravings for opioids
- Nausea, vomiting, and diarrhea
- Loss of appetite
- Shaking
- Watery eyes and a runny nose
- Insomnia
Occasionally, individuals who have more severe withdrawals can experience serious side effects like seizures. That’s why a medical detox from a treatment center that provides around-the-clock supervision is a good idea to ensure safety when coming off drugs like Percocet or Vicodin.
The NIH states that the main symptoms of opioid withdrawal will typically last between 4-20 days, depending on the drug and severity of addiction. However, some mental symptoms like cravings can still linger months after stopping prescription opioid use, which is why longer-term treatment can be a good idea.
Treatment for Prescription Opioid Abuse
When you or a loved one is struggling with addiction to opioids like Vicodin and Percocet, we offer many options that can help at Genesis House. Our treatment options include medical detox, inpatient treatment, and outpatient treatment.
All our programs are tailored to you with different types of therapy, family support, and dual-diagnosis treatment while using evidence-based practices that ensure high success rates.
Our team at Genesis House is here to help. Contact us today to learn more about our treatment options and how we can support your needs.
References
- Centers for Disease Control and Prevention. “About Prescription Opioids.” Overdose Prevention, 8 May 2024, https://www.cdc.gov/overdose-prevention/about/prescription-opioids.html
- Zacny, James P., and Sandra Gutierrez. “Within-Subject Comparison of the Psychopharmacological Profiles of Oral Hydrocodone and Oxycodone Combination Products in Non-Drug-Abusing Volunteers.” Drug and Alcohol Dependence, vol. 101, no. 1-2, Apr. 2009, pp. 107–114, doi:10.1016/j.drugalcdep.2008.11.013. https://pubmed.ncbi.nlm.nih.gov/19118954/
- SLAWSON, DAVID. “No Difference between Oxycodone/Acetaminophen and Hydrocodone/Acetaminophen for Acute Extremity Pain.” American Family Physician, vol. 93, no. 5, Mar. 2016, pp. 411–411, https://www.aafp.org/pubs/afp/issues/2016/0301/p411.html
- National Library of Medicine. “Acetaminophen.” gov, National Institute of Diabetes and Digestive and Kidney Diseases, 28 Jan. 2016, https://www.ncbi.nlm.nih.gov/books/NBK548162/
- Onset, Peak, and Duration of Common Pain Medications. Department of Health and Human Services (HHS), https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/QMP/PainMedicationTable.pdf
- Cicero, Theodore J., et al. “Factors Influencing the Selection of Hydrocodone and Oxycodone as Primary Opioids in Substance Abusers Seeking Treatment in the United States.” Pain, vol. 154, no. 12, Dec. 2013, pp. 2639–2648, doi:10.1016/j.pain.2013.07.025. https://journals.lww.com/pain/abstract/2013/12000/factors_influencing_the_selection_of_hydrocodone.12.aspx
- Harris, Rebecca Arden, et al. “Long-Term Use of Hydrocodone vs. Oxycodone in Primary Care.” Drug and Alcohol Dependence, vol. 205, Dec. 2019, p. 107524, doi:10.1016/j.drugalcdep.2019.06.026. https://www.sciencedirect.com/science/article/abs/pii/S0376871619302832
- “Withdrawal Management.” gov, National Institutes of Health, 2009, https://www.ncbi.nlm.nih.gov/books/NBK310652/
